Pseudoprogression of CNS metastatic disease of alveolar soft part sarcoma during anti-PDL1 treatment

Thomas A. Vander Jagt, Lara E. Davis, Meghna Das Thakur, Carl Franz, Jeffery M. Pollock

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Immune checkpoint inhibitors are increasingly used in treatment of metastatic renal cell carcinoma, melanoma, and nonsmall cell lung cancer, as well as in clinical trials for novel targets. We present a pediatric patient with metastatic alveolar soft part sarcoma who was treated with MPDL3280 (Atezolizumab), a monoclonal anti-programmed death ligand-1 antibody. Imaging results for the patient suggested disease progression of multiple brain metastases with stable systemic disease. The patient met response evaluation criteria in solid tumors (RECIST) criteria of progression of disease and was removed from treatment with MPDL3280. Subsequent surgical resection of the brain lesions revealed nonviable tumor with extensive lymphocytic infiltrates consistent with pseudoprogression. This case report adds to a growing number of reports that question reliance on RECIST criteria and suggest need for further refinement of RECIST or irRECIST during immune checkpoint inhibitor treatment for central nervous system metastatic lesions.

Original languageEnglish (US)
Pages (from-to)882-885
Number of pages4
JournalRadiology Case Reports
Issue number4
StatePublished - Aug 2018


  • Alveolar soft part sarcoma
  • PDL1
  • Pseudoprogression

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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